非胰岛素依赖型糖尿病患者血清中抗GAD抗体的临床意义

Clinical significance of GAD-Ab in serum of NIDDM patients

目的：探讨谷氨酸脱羧酶抗体（ＧＡＤ－Ａｂ）对糖尿病诊断的临床意义。方法：用间接ＥＩＡ法测定了１１０例初诊为非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者血清中ＧＡＤ－Ａｂ。结果：１１０例ＮＩＤ－ＤＭ患者中ＧＡＤ－Ａｂ总阳性率为１９．１％，胰岛细胞抗体（ＩＣＡ）阳性率１２．７％，ＩＣＡ阳性者全部检出ＧＡＤ－Ａｂ，而ＧＡＤ－Ａｂ阳性者ＩＣＡ的阳性率６６．７％，而且ＧＡＤ－Ａｂ阳性的病人具有胰岛素依赖型糖尿病（ＩＤＤＭ）的临床特点，即低体重指数及低胰岛素分泌功能。结论：血清中ＧＡＤ－Ａｂ的测定是早期预报及诊断ＩＤＤＭ的最灵敏的免疫标志，而且对于早期诊断“成人晚发自身免疫性糖尿病（ＬＡＤＡ）”，及时给予胰岛素治疗，防止糖尿病眼、肾、神经并发症具有重要的临床意义。

Objective:To inquire into the clinical significance of the diagnosis of diabetes mellitus by glutamate decarboxylase antibogy (GAD-Ab).Methods:We measured 110 patients who were diagnosed as noninsulindependent diabetes mellitus (NIDDM) with EIA indirectly.Results:Total positive rate of GAD-Ab was 19.1% of these 110 NIDDM patients.Positive rate of islet cell antibody (ICA) was 66.7%,and patients who was positive in GAD-Ab had the clinical characters of insulindependent diabetes mellitus (IDDM) i.e. low body weight index and low insulin secreting function.Conclusion:The measures of GAD-Ab in serum are the most sensitive immunologic symbol in early forecast and diagnosis of IDDM,and have the important clinical significance in the diagnosis of latent autoimmuue diabetes mellitus in adults (LADA) in early stage,in the treatment with insulin in time,and in the prevention of the complications of diabetes mellitus in eye,kidney and nervous system.